DES MOINES, Iowa - Health disparities in the United States are getting more attention, between the pandemic and last year's social-justice protests. In Iowa, certain barriers are being addressed, including mistrust of health agencies and providers.

State health officials have said Iowa mirrors national data for people of color experiencing negative health outcomes. They have noted that the state's Black population has the highest rate of mortality in almost every cause of death, not including suicide.

Izaah Knox, executive director of Urban Dreams, a statewide nonprofit that helps reduce racial barriers, said he feels that, in terms of outreach, the health-care industry has lacked a strong presence in marginalized neighborhoods.

"I think the biggest thing," he said, "is that too many times organizations, hospitals - or anybody that all of a sudden wants to reach out - only comes out every once in a while, and if it's of benefit to them. "

He said that's why his group is partnering with others, such as the American Heart Association, to maintain a consistent presence. The Heart Association is advocating for increased state funding for a program to help marginalized Iowans get healthier foods at a lower cost. The group has said expansion of tele-health is another priority in closing these gaps.

Nalo Johnson, division director of health promotion at the Iowa Department of Public Health, agreed that improved engagement can help make these communities more resilient, especially during public-health emergencies. She said the state is trying to ramp up support for lower-level agencies in this area.

"Providing resources around translation; providing connections from what we are hearing or seeing at the federal level, in terms of resources or information," she said.

Through grant opportunities, the department also is trying to reduce disparities for diseases such as hypertension. Community groups have said policymakers need to bolster infrastructure in poorer neighborhoods, so residents can be more mobile and improve their physical health. On its website, the American Heart Association has more information on efforts to end structural racism and other initiatives to improve health outcomes in states such as Iowa.

A New Mexico resident will attend President Joe Biden's State of the Union address tonight as legislation is pending to expand the Radiation Exposure Compensation Act.

The measure was passed in 1990, with money going to residents of the Southwest who were harmed, either from uranium mining or atomic tests in 1945. The original legislation included "downwinders" in Arizona, Utah and Nevada. But New Mexico was left out, despite the state being home to the world's first atomic bomb testing and explosion.

Tina Cordova, co-founder of the Tularosa Basin Downwinders Consortium, has made it her life's work to get New Mexico families compensated.

"I've been working for 19 years to bring attention to the negative health effects the people of New Mexico suffered," Cordova explained. "The Trinity bomb was detonated in the middle of our state and adjacent to a bunch of towns where 13,000 people lived in a 50-mile radius."

Cordova was invited to the annual Presidential address by Sen. Ben Ray Luján, D-N.M. In the coming days, the Senate is scheduled to vote on legislation to reauthorize the act, now scheduled to end in June.

Cordova pointed out the more than 30-year-old compensation program was an admission of guilt on the part of the government but left out many of those harmed. She knows families who have lost relatives to cancer, some within 10 years of the nuclear bomb testing.

"I just hope that people who know I'm present, realize that we will never give up the fight," Cordova asserted. "We will work very hard to get the RECA amendments passed this year, but if by some chance that doesn't happen, we will continue to fight this fight for justice as long as it takes."

This Sunday, the Hollywood blockbuster, Oppenheimer, about the creation of the atomic bomb, is a favorite to win best picture at the 2024 Academy Awards. The film did not address effects to those downwind of the bombing site.


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A new report finds Connecticut's recently released prison population is facing reentry challenges.

The State of Reentry report found resources and services are lacking for formerly incarcerated people. Between 2022 and 2023, 14% of the population said they would be homeless upon release.

It is just the tip of the iceberg as many of the state's Reentry Welcome Centers reported most of their clients were housing unstable.

Scott Wilderman, president and CEO of Career Resources, said it can be attributed to numerous factors including the stigma of being an ex-offender.

"We have to do a better job of educating and working with landlords and try to encourage them to give individuals a second chance," Wilderman contended. "There's no doubt about that. The sad part is, with returning citizens or ex-offenders, there's really no such thing as an ex-offender since everybody always sees the offense."

He thinks Connecticut should focus more on justice reinvestment. Other criminal justice advocates have called for using funds saved by closing prisons to invest in reentry centers. The centers are not funded by the state and have been subsisting on American Rescue Plan funds. When the money expires at the end of the year, it is uncertain how they will be able to help people with life after prison.

Given it is the third year of the report, Wilderman acknowledged there have not been many changes, but he found it surprising, noting there has been plenty of time to make improvements, specifically in areas like education.

"We know education is the great equalizer and having a high school diploma is essential," Wilderman asserted. "It just opens a lot more doors for an individual as it's often a requirement for employment, or in some cases going after further education or job training."

The report noted 66% of incarcerated people with sentences ending in six months said they did not have a high school diploma. Enrollment is down in programs for incarcerated people to complete their degrees. One reason for it is Connecticut's ongoing teacher shortage.


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After a five-year court battle, New Jersey's medical aid-in-dying law has been affirmed by the state's Supreme Court, which rejected an attempt to overturn the statute.

Signed by the governor in 2019, the law was soon challenged by a physician based on religious, personal and constitutional grounds. It allows mentally capable, terminally ill adults with six months or less to live to get a prescription they can use to end their lives.

Dr. Paul Bryman, a hospice and palliative care physician, is an advocate for medical aid in dying for people who feel their suffering is intolerable.

"I think it's important that that option is available for people who choose to avail themselves of it. It's not for everyone and it's someone's choice whether they want to use that. No one's forced to do it," he explained.

Bryman practices geriatric and internal medicine and believes there are adequate legal safeguards to make sure patients are protected. The law was briefly suspended in August 2019, but reinstated 13 days later as court proceedings continued.

The nonprofit group Compassion & Choices expressed support for the decision as well as expanded and improved end-of-life care options.

Alan Howard, Compassion & Choices attorney, urged the justices to uphold a lower court's ruling.

"We are grateful that the Supreme Court recognized that there are terminally ill New Jersey residents who are counting on this end-of-life care option to bring them peace of mind during this difficult time," said Howard. "Dying people should have this compassionate option to peacefully end their suffering if it becomes unbearable."

Bryman added a total of 186 terminally ill New Jerseyans have used the medical aid-in-dying law and believes the court made the right decision.

"I'm glad that it's finally over and that this law's available for people in New Jersey who have the right to their own health-care decisions," he said.

In addition to New Jersey, Washington, D.C., and nine other states, which represent 22% of all Americans, have authorized medical aid in dying.